PREDICTION OF DELAYED CEREBRAL-ISCHEMIA, REBLEEDING, AND OUTCOME AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE
PREDICTION OF DELAYED CEREBRAL-ISCHEMIA, REBLEEDING, AND OUTCOME AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE
复制标题
DOI：
10.1161/01.str.19.10.1250
复制
发表时间：
1988-10-01
期刊：
影响因子：
8.3
通讯作者：
VANCREVEL, H
中科院分区：
文献类型：
--
作者：
HIJDRA, A;VANGIJN, J;VANCREVEL, H
使用逻辑回归分析，我们分析了一些输入变量对蛛网膜下腔出血患者迟发性脑缺血、再出血和预后不良（死亡或严重残疾）的预测价值。入组变量为入院时的临床状况（格拉斯哥昏迷量表，Hunt和Hess系统分级）、蛛网膜下腔和脑室内血液量、入院时计算机断层扫描显示的脑积水和氨甲环酸抗纤溶治疗。我们使用的数据来自一个前瞻性研究人群，176例患者在蛛网膜下腔出血后72小时内入院。迟发性脑缺血的风险最好通过蛛网膜下腔血、脑室内血和抗纤溶治疗的量来预测，而不考虑临床状况和脑积水。迟发性脑缺血的部位与蛛网膜下腔出血的部位无关。抗纤溶治疗是预测再出血风险的唯一输入变量（阴性）。3个月后的死亡或严重残疾最好通过蛛网膜下腔出血量和格拉斯哥昏迷评分反映的初始临床状况来预测。
Using logistic regression, we analyzed the predictive value of a number of entry variables with respect to the outcome variables delayed cerebral ischemia, rebleeding, and poor outcome (death or severe disability) in patients with aneurysmal subarachnoid hemorrhage. The entry variables were clinical condition on admission (grades on the Glasgow Coma Scale, Hunt and Hess System), the amount of subarachnoid and intraventricular blood and the presence of hydrocephalus on the admission computed tomogram, and antifibrinolytic treatment with tranexamic acid. We used data from a prospectively studied population of 176 patients admitted within 72 hours after subarachnoid hemorrhage. The risk of delayed cerebral ischemia was best predicted by the amount of subarachnoid blood, intraventricular blood, and antifibrinolytic treatment irrespective of clinical condition and hydrocephalus. The site of delayed cerebral ischemia was not related to the location of the subarachnoid hemorrhage. Antifibrinolytic treatment was the only entry variable (negatively) predicting the risk of rebleeding. Death or severe disability after 3 months was best predicted by the amount of subarachnoid blood and the initial clinical condition reflected by the grade on the Glasgow Coma Scale.